In “SSRI Prescribing Rates and Adolescent Suicide: Is the Black Box Hurting or Helping?” (Psychiatric Times, October 2007, page 33) Gibbons and associates primarily use data from their American Journal of Psychiatry article that appeared in September 2007, in a not very veiled attempt to influence doctors and the FDA to roll back the “black-box” warning on the prescription of SSRIs for adolescents.
In the Valley of Elah is an improvised explosive device that writer-director Paul Haggis has set to go off in the hearts and minds of Americans who still support the war in Iraq. Haggis, who earned an Oscar (Best Picture and Screenplay) for Crash, has aimed his second film at the hardworking, churchgoing, flag-flying, decent Americans who cannot imagine that the country they love would engage in an unjust war.
Medication adherence, especially in children and adolescents, is a complex problem that is poorly understood and underresearched, yet it is a clear barrier to effective treatment and is frequently encountered in everyday clinical practice.
Reducing complex human experiences into a psychiatric diagnosis can be a daunting task. For children with developmental disorders, this process is even more complicated and requires distilling often incomplete and frequently contradictory scientific evidence.
In an earlier column (Psychiatric Times, “The Road Less Traveled,” September 2002, page 14), I emphasized what can be learned from interviewing nonclinical subjects.
Over the past decade, NSAIDs have been on a roller-coaster ride almost as wild as that now being experienced by this country’s housing and financial markets. The selective COX-2 inhibitors-first celecoxib (Celebrex) and then rofecoxib (Vioxx) and valdecoxib (Bextra)-promised to revolutionize the treatment of pain.
Recent research has raised concerns about the adequacy of psychiatric diagnostic evaluations conducted in routine clinical practice, particularly the detection of disorders that are comorbid to the principal diagnosis.
When I was recently asked by a patient about the link between osteoporosis and SSRIs, I dimly recalled this topic’s emergence in a medical journal in 2007, its subsequent meander through several newsletters, and its gradual return to the bottom of my mental risk-assessment checklist.
Commercially available telephone sex with women has been available at all hours of the day or night for over 25 years to anyone who pays the fee.
Recently, I was involved in a discussion with several other mental health writers and editors regarding the most appropriate term to use for those we treat: patient or client. Our lack of consensus reflected that in contemporary medical and psychiatric literature.
When most people think of bullying, they envision the schoolyard thug verbally or physically threatening hapless victims on the playground or on the school bus. The past few years, however, have witnessed a new type of bullying-cyber bullying-also known as electronic bullying or online social cruelty.
Diagnostic assessment of psychiatric disorders and their comorbidities is a challenge for many clinicians. In emergency settings, there is no time to conduct lengthy interviews, and collateralinformation is often unavailable.
In the new century, the dementias will probably become 1 of the 2 or 3 dominant behavioral health problems in the United States. This article provides an overview of the major clinical features of these cognitive loss syndromes and emphasizes the perspective of the practicing psychiatrist.
Emergency medicine provides care to a vast number of patients each year. In 2005, 115.3 million people visited emergency departments (EDs).
As a licensed acupuncturist, I am often asked by both medical professionals and laypersons whether acupuncture actually “works” and whether it should really be considered part of a belief system rather than science.
We often describe neural connections in the brain as if they were a cellular version of Michelangelo’s famous painting “Hand of God Giving Life to Adam,” on the ceiling of the Sistine Chapel.
The use of antipsychotics to quiet agitated older adults with dementia has come under increasing fire. After a Canadian study demonstrated an increased risk of adverse events or death with these agents,1 the FDA expanded its earlier warning to physicians.
Neuroimaging is often used in clinical psychiatry to rule out medical and neurological conditions that can mimic psychiatric disease rather than for the diagnosis of specific psychiatric disorders.
Gambling has become a major recreational activity in the United States. Formerly confined to a few states such as Nevada and New Jersey, legal gambling opportunities have exploded across the nation in the past 2 decades.
William Bruce, a young man with symptoms of paranoid schizophrenia, was released from Maine’s state-run Riverview Psychiatric Center in April, 2006. Two months later, he killed his mother with a hatchet. Bruce subsequently was found not criminally responsible by reason of insanity and was recommitted to Riverview.
We need to have a framework to make certain that our interventions are balanced, safe, and a function of the existing evidence.
Participants in past meetings of the FDA’s Psychopharmacologic Drugs Advisory Committee (PDAC) think changes to FDA advisory committee procedures announced in August will add credibility to those committee votes.
A strategic plan to guide research priorities and resource allocations of the NIMH was released recently by NIMH Director, Thomas R. Insel, MD. The plan is intended to provide direction over the next 5 years toward the institute’s stated vision of “a world in which mental illnesses are prevented and cured.”
The high rate of comorbid substance abuse in women with bulimia nervosa (BN) has remained consistent in the literature. This article reviews the prevalence of substance abuse in BN and summarizes treatment approaches for persons with BN and comorbid substance abuse.
Two recent studies on the treatment of depression in children and adolescents will help guide clinicians’ treatment decisions.
Adolescents who present with symptoms that suggest a psychotic disorder pose a number of diagnostic and treatment challenges. This article attempts to provide a practical guide to the assessment and management of adolescents with severe psychotic illness, including schizophrenia, schizophrenia-like disorders, and bipolar disorder.
I have been invited to write a clinical article on psychotherapeutic interventions for chronic depression.
A 52-year-old female college professor was referred to a psychiatrist by a nurse practitioner at the college health clinic. The referring diagnosis was “adjustment disorder with depressed mood versus atypical depression with somatization; rule out fibromyalgia.”
Both the American Psychiatric Association (APA) and the Accreditation Council for Continuing Medical Education (ACCME) are embroiled in the widening Senate investigations of pharma’s possible influence on CME in particular and on medicine in general.
